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Associations of coping styles with nonsuicidal self-injury in adolescents: Do they vary with gender and adverse childhood experiences?Wan, Yuhui; Chen, Ruoling; Wang, Shan-Shan; Clifford, Angela; Zhang, Shichen; Orton, Sophie; FangbiaoTao; Department of Maternal, Child& Adolescent Health, School of Public Health, Anhui Medical University, China; Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China; Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK. (Elsevier BV, 2020-03-29)© 2020 Elsevier Ltd Background: The impact of positive coping style on non-suicidal self-injury in adolescents remains unclear, while negative coping style increases the risk of non-suicidal self-injury (NSSI). There is less investigation on gender differences in the impacts of positive coping style and negative coping style on NSSI. It is unknown whether the impacts vary with different levels of adverse childhood experiences (ACEs). Aims: To identify gender differences in the impacts of positive coping style and negative coping style on NSSI, and investigate the impacts at different levels of ACEs. Method: An adolescent health survey was conducted in 15 schools in China between November 2013 and January 2014. 9704 students aged 11–19 years completed standard questionnaires to record the details of coping style, NSSI and ACEs. Results: 38.5 % of adolescents had ≥1 NSSI over the past 12 months. NSSI was significantly increased with the low positive coping style in girls with ≥3 ACEs, but not with 0 and 1−2 ACEs, and not in boys with any levels of ACEs. NSSI was increased with high negative coping style in both girls and boys across all ACEs. The negative coping style impact was stronger in girls than in boys (odds ratio 1.66, p < 0.05), especially in those with 1−2 ACEs. Conclusions: Adolescents at high risk of NSSI in relation to coping styles should be targeted accordingly. Reducing negative coping style in girls and boys and improving positive coping style in girls who have high ACEs could help prevent NSSI in adolescents.
Effects of self-esteem on the association between negative life events and suicidal ideation in adolescentsWan, Yuhui; Chen, Ruoling; Wang, Shan-Shan; Orton, Sophie; Wang, Danni; Zhang, Shichen; Sun, Ying; Tao, Fangbiao; Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China. (MDPI AG, 2019-08-09)© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Negative life events (NLEs) increase the risk of suicidal ideation (SI) in adolescents. However, it is not known whether the association between NLEs and SI can be moderated by self-esteem and varies with gender. The aim of the current paper was to examine gender differences in the association of SI with NLEs in adolescents, and assess the effects of self-esteem on the association and their gender variations. We conducted a school-based health survey in 15 schools in China between November 2013 and January 2014. A total of 9704 participants aged 11–19 years had sociodemographic data reported and self-esteem (Rosenberg self-esteem scale), NLEs, and SI measured. Multivariate-adjusted logistic regression was used to calculate the odds ratio (OR) of having SI in relation to NLEs. Increased risk of SI was significantly associated with NLEs (adjusted OR 2.19, 95%CI 1.94–2.47), showing no gender differences (in females 2.38, 2.02–2.80, in males 1.96, 1.64–2.36, respectively). The association was stronger in adolescents with high esteem (2.93, 2.34–3.68) than those with low esteem (2.00, 1.65–2.42) (ORs ratio 1.47, p = 0.012). The matched figures in females were 3.66 (2.69–4.99) and 2.08 (1.61–2.70) (1.76, p = 0.006), while in males these figures were 2.27(1.62–3.19) and 1.89 (1.41–2.53) (1.20, p = 0.422), respectively. Self-esteem had moderate effects on the association between NLEs and SI in adolescents, mainly in females. NLEs, self-esteem, and gender need to be incorporated into future intervention programs to prevent SI in adolescents.